Best Care Assisted Living on Haskell

Allegation investigated: Staff did not safeguard resident's personal belogings.

At 12:00pm LPA, Licensing Program Analyst (LPA) Angela Panushkina, conducted an unannounced complaint visit in response to the above-mentioned allegation. LPA met with the Administrator and explained the reason for the visit. At 12:05pm, LPA requested resident and staff roster. At 12:10pm, LPA requested copies of pertinent information which include, but not limited to Admission Agreement, Physicians Report, Appraisal Needs and Services Plan, Theft and Loss Policy, Staff Training, etc. relevant to the investigation. At approximately 12:20pm, LPA conducted a physical plant tour. Between 12:30am – 2:30pm, LPA conducted an interview with the Administrator, two (2) staff and six (6) residents. Continue on LIC9099-C Unsubstantiated Allegation: Staff did not safeguard resident's personal belongings. It was alleged that R1 was hospitalized in December 2025 and subsequently transferred to a rehabilitation on 12/05/2025, where R1 remained until 03/20/2026, and the staff did not safeguard R1’s personal belongings. LPA conducted an interview with the Administrator, who denied the allegation and stated that R1 has a history of reporting missing items at various times. Administrator reported that the facility made arrangements for R1 to pick up belongings and requested that law enforcement be present to ensure transparency and safety during the process. According to the Administrator, R1 refused to participate in the police accompanied pick-up and allowed the Administrator to video the process of collecting some or all of their belongings. Staff interviewed confirmed the statement provided by the Administrator and stated that they do not recall an instance of R1’s personal items being mishandled or lost while stored at the facility. Staff confirmed that some belongings were stored in boxes, due to R1’s extended absence but stated they were maintained in R1's room #1, which was kept locked during that time. All six (6) residents interviewed denied having any issues with staff safeguarding their belongings. Each resident stated they had never experienced missing personal property, and they had not observed staff mishandling or misplacing items/belongings of the residents. Lastly, LPA was provided with pictures of R1's room and observed, multiple empty bottles and gloves, cream, coins, trash, etc. on the floor. R1's bed was piled up with purses, hangers and various items. LPA was informed that R1 refused to comply with the facility house rules and did not allow staff to clean their room. Therefore, based on interviews and information gathered this allegation is deemed Unsubstantiated, at this time. No deficiency issued during today's visit. Exit interview conducted and copy of this report signed and delivered.the state’s words, verbatim · CDSS document, May 7, 2026 · control 31-AS-20260430120837

Allegation investigated: Staff over medicated a resident contributed to residents death. Staff did not keep facility free of an illegal substance. Staff placed a resident on hospice without authorization.

On 12.30.2025 at 9:00 AM, Licensing Program Analyst (LPA) Leslie Ngo-Castaneda arrived at this facility to conduct an unannounced subsequent complaint visit to deliver the final determination of the above-noted allegations. LPA was granted entry into the facility by the staff #1 (S1) and explained the reason for the visit. An entrance interview was conducted. At the time of this visit, at approximately 9:10 AM, LPA conducted a physical plant tour of the facility. LPA did not observe any immediate health and safety issues. To investigate the allegations, prior to the initial visit on 4.7.2025, LPA Ngo-Castaneda subpoenaed medical records from the hospital. Continue to LIC 9099-C Unsubstantiated On 04/08/25, LPA Ngo-Castaneda conducted an initial complaint visit at which time, at approximately 10:19 AM, LPA conducted a physical plant tour of the facility. From 12:30 PM – 1:30 PM, LPA interviewed three (3) staff members present in the facility and five (5) residents. At 11:00 AM, LPA requested copies of pertinent information which included, but not limited to Physician’s report, Admission Agreement, Staff Training, LIC 500, resident roster, needs and service plan, and other relevant documents to the investigation. Before this visit on 4.7.2025, LPA reviewed the documents previously gathered from the facility. Allegation #1: Staff over medicated a resident contributed to resident’s death. It was alleged that facility staff over-medicated resident #1 (R1), resulting/contributing in their death. LPA interviewed five (5) residents on 4.8.2025, and it was revealed that residents do not have any issues with staff over medicating anyone at the facility. During interviews with staff, it was revealed that all medications are given as prescribed. LPA reviewed R1’s medical records, which revealed that on 3.21.2025, no drug overdose was found in R1's system. R1’s death was due to ‘cardiac arrest’ on 4.1.2025. Based on interviews and record review, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time. Allegation #2: Staff did not keep the facility free of an illegal substance. It was alleged that the facility kept an illegal substance that R1 took and consumed. During LPA Ngo-Castaneda facility plant tour, medication review, and observation, LPA did not observe any ‘illegal substance’ in the facility. During interviews with staff, it was revealed that all medications are given as prescribed. All of the staff confirmed that no one uses or sells drugs in the facility. During interviews with residents, all interviewed residents stated that they were given their medications as prescribed. Residents revealed no occurrences of illegal drug use or sales in the facility. Based on interviews and record review, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time. Continue to LIC 9099-C Allegation #3: Staff placed a resident on hospice without authorization. It was alleged that R1 was placed on hospice care without their consent. LPA phone interview with R1 family at 12:15 PM on 4.8.2025 revealed that R1’s family was aware of what they signed and was advised on the services that hospice will provide. LPA interview with staff revealed that R1 was admitted at the facility on 1.17.2025. Before being admitted to the facility, R1's family signed and agreed to R1 to receive hospice care. R1’s hospice care was approved by Circle of Life Hospice coverage on 1.01.2025. Based on the information provided and record review, the allegation is deemed to be UNSUBSTANTIATED at this time. No immediate health or safety hazards were observed during today’s visit. Exit interview conducted. Copy of this report provided.the state’s words, verbatim · CDSS document, Dec 30, 2025 · control 31-AS-20250404163531

Type of visit: Case Management - Deficiencies

In conjunction with the complaint investigation, (complaint number # 31-AS-20250404163531), Licensing Program Analyst (LPA) Leslie Ngo-Castaneda conducted a case management visit to address the deficiencies unrelated to the complaint. During the complaint investigation, completed by Senior Investigator (SI) Heidy Bandana it was found that on 2.24.2025, R1 primary care physician (PCP) discontinued the prescription for Hydrocodone- Acetaminophen (Norco) tablet, 5-325 mg, two tablets every six hours as needed. According to R1’s PCP, they wrote a new prescription for Hydrocodone-Acetaminophen (Norco) tablet, 10-325, one tablet every four hours as needed. Per centrally stored medication and destruction records (CSMDR), reviewed by SI-Bendana, the facility was giving R1 two tablets of Hydrocodone-Acetaminophen instead of one as prescribed as of 02.24.25. In addition, Incident report dated 3.21.2025, started at 1100 hours, R1 took his prescribed Hydrocodone 10-325 mg; then the incident report also stated R1's last dose was administered at 1000 hours. The day of the incident, R1 was found sweaty, warm to the touch, unresponsive, drooling, with snoring respiration. R1 became somewhat alert after paramedics administered two Narcan injections. Based on the interviews, and record review, the facility failed to provide proper medication assistance to R1, which reflected R1’s health and safety. A deficiency is cited on the corresponding LIC 809-D page. Deficiencies Cited. Exit Interview Conducted. Report Issued. Licensee was informed that an immediate Civil Penalty of $500.00 will be issued to the facility at the time of this visit. Additional civil penalty maybe be assessed at later time based on Health and Safety Code 1569.49. Exit interview was conducted. Appeal rights discussed and a copy of report was issued.the state’s words, verbatim · CDSS document, Dec 30, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(c)(2) · Plan of correction due date: Dec 31, 2025

Incidental Medical and Dental Care Services. Once ordered by the physician, the medication is given according to the physician's directions. This requirement is not met as evidenced by: Based on the information obtained during the course of the investigation, staff did not comply with the section cited by failing to ensure R1's Norco medication was given as prescribed, which posed an immediate health and safety and personal rights risk to R1.the state’s words, verbatim · CDSS document, Dec 30, 2025

Plan of correction: Within 24 hour the Licensee will provide written plan of action explaining the steps they will take to avoid similar issues from happening again. Medication training through the licensed vendor must be secured within 24 hours and training records will be provided upon completion.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Leslie Ngo-Castaneda conducted an annual required visit and inspection of the facility. LPA was greeted with staff Daniyar Kusoangaliyev and Robert Mkrttchian and was advised for the reason of the visit. At 9:30 AM who is the designee met with LPA, explained the reason for the visit. At 10:00 AM, with the assistance of designee, LPA took a tour of the physical plant. Required postings were observed in the entry area. At 11:36 AM the smoke alarms are operational that are located each bedroom, the hallway and kitchen. There are carbon monoxide detectors that functions properly. The fire extinguisher is in the kitchen. The charge date is 11/7/2024. During the visit the facility is at 73 degrees Fahrenheit. The facility is fire cleared maybe for six (06) non-ambulatory residents, one (1) bedridden room #4. Hospice waiver for six (6). Kitchen: The kitchen appliances and fixtures were functional. The kitchen has a working gas stove, faucet, freezer, refrigerator, and microwave. LPA found enough at least two (2) days perishable and seven (7) days non-perishable food at the facility that is properly stored. Frozen foods are wrap, dated, and stored properly as well. Knives were stored in a locked drawer in the kitchen. Food storage and preparation areas are clean and inaccessible to pests. Garbage cans have tight fitting covers. Cleaning supplies, pesticides or toxic cleaning supplies were stored and locked away in the locked laundry area. Office is located beside the living room. Bedrooms: There were four (4) bedrooms designated for residents' use. Bedroom #1 and bedroom #3 are for private used. Bedroom #2 and bedroom #4 are shared and is used for residents only, Bedrooms were properly furnished with appropriate dresser, beddings, and linens with sufficient lighting. Continue to LIC 809-C BATHROOMS: At 1:10 PM LPA observed three (3) bathrooms are clean and in good repair. Properly supplied with toilet papers, soap, and paper towels. The hot water temperature measured between 119.5°F. observed appropriate grab bar and had non-skid mat. Bathroom #1 is located in the hallway beside the entrance of the facility. Bathroom #2 is located inside bedroom #3 for private use. Hot water for bathroom #2 measured at 113.2°F. Bathroom #3 is located inside bedroom #4 for private use. Hot water for bathroom #3 measured at 118.1°F. Common Areas: LPA toured all common areas of the facility. These included the living room and dining area for residents. The common areas were properly furnished. Residents dining table fits enough for six (6). LPA observed common areas to be very clean and tidy. LPA observed the floors to be in very good condition. No obstructions and or tripping hazards throughout the facility. Furniture in common area was observed to be in good repair. There are no issues with Fire Clearance. Infection control: Facility mitigation plan to make sure licensee was following current infection control recommendations. LPA obtain a copy and reviewed the infection control plan during this visit. Surrounding Grounds: Entry and exits were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area was free of hazards. The facility does not have a swimming pool or bodies of water. There is no garage in the facility only street parking. Laundry service: There is enough linen available to change weekly or more if need. Cleaning supplies are being stored in a locked cabinet in the laundry area and is located beside the kitchen. Staff Files: LPA also conducted a file review of staff records to ensure forms and training are up to date and compliance with licensing forms. Office is located beside the dining table. Records were checked for expired or missing certificates and clearances: LPA conducted a file review of staff for criminal record clearances and current First Aid. The administrator file was reviewed for current first aid, fingerprint clearance, administrator certificate, and HIV/AIDS and TB training. Continue to LIC 809-C Medications are in a centrally stored and locked place, including over-the-counter medicines; medications are properly labeled and checked for expiration dates. Each centrally stored prescription and PRN medication has been logged in the medications log with proper documentation from the residents’ physician. It was observed on 12:30 PM R1 and R4 medication were pop-out of the bubble pack and prep in a cup for the residents to take later tonight. Deficiency will be cited on LIC 809-D. First-aid has all proper items and is current. Resident records were reviewed for requirements and legibility: LPA reviewed client’s files for current appraisal. Planned activities are offered. Facility is not within CA code of Regulations Title 22 or Health and Safety Code. Deficiencies were found, exit interview conducted, copy of report has been issued and discussed.the state’s words, verbatim · CDSS document, Jul 23, 2025

Type of visit: Case Management - Deficiencies

On 4.8.2025 in conjunction with an initial complaint visit control number 31-AS-20250404163531. Licensing Program Analyst (LPA) Leslie Ngo-Castaneda completed an unannounced CASE MANAGEMENT- Deficiencies visit. LPA met with staff designee Sona Gevorkyan, explained the purpose of the visit. During the facility tour at 10:19 AM . LPA observe the following: Facility did not notify Regional Office (RO) regarding resident #1 (R1) being in hospice. Upon record review, LPA observed facility medications and supplies to have surplus that were from residents who are no longer at the facility. Per the California Code of Regulations (CCR), Title 22, Division 6, Chapter 8, the following deficiency was observed and cited (Refer to LIC 809-D). Copy of this report provided, appeal rights given. Exit interview conducted.the state’s words, verbatim · CDSS document, Apr 8, 2025

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87632(d)(2) · Plan of correction due date: Apr 22, 2025

The licensee shall notify the Department in writing within five working days of the initiation of hospice care services for any terminally ill resident in the facility or within five working days of admitting a resident already receiving hospice care services. The notice shall include the resident's name and date of admission to the facility and the name and address of the hospice. Based on record review, administrator did not comply with the above section by failing to report R1 being in hospice, which poses an immediate health, safety and personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Apr 8, 2025

Plan of correction: Administrator agreed to send hospice notification to RO of R1. Administrator will sign a declaration that they will ensure the facility abides by the regulation cited. Signed declaration will be sent to LPA by POC date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87465(i) · Plan of correction due date: Apr 22, 2025

Prescription medications which are not taken with the resident upon termination of services, not returned to the issuing pharmacy, nor retained in the facility as ordered by the resident’s physician and documented in the resident’s record nor disposed of according to the hospice’s established procedures or which are otherwise to be disposed of shall be destroyed in the facility by the facility administrator and one other adult who is not a resident. Based on record review, administrator did not comply with the above section by failing to dispose residents medication and supplies who are not residing at the facility, which poses an immediate health, safety and personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Apr 8, 2025

Plan of correction: Administrator agreed to dispose and remove rx that belong to residents who are not residing at the facility anymore. Administrator will sign a declaration that they will ensure the facility abides by the regulation cited. Signed declaration will be sent to LPA by POC date.

Type of visit: Prelicensing

At 9:38am Licensing Program Analysts (LPAs), Leslie Ngo-Castaneda and Leizl De La Cerra conducted an announced pre-Licensing visit for a change of ownership to the above facility and met with Administrator, Sona Gevorkyan. Fire Clearance was approved on 1/30/2024 for a maximum capacity of six (6) residents, of which six (6) Non-Ambulatory and one (1) bedridden residents in room #4; hospice for six (6). The purpose of today’s visit is to inspect the facility to ensure that the facility is in compliance with rules and regulations under California Code of Regulations, Title 22, Division 6. The facility is a single-story building. Today's site visit consisted of team touring the physical plant inside and outside and observed the following: KITCHEN: The kitchen is equipped with a refrigerator, freezer, microwave oven and sink. At 10:34am, the team observed adequate supplies of perishable and nonperishable food and dining ware to accommodate a maximum capacity of six (6). All knives and sharps are observed to be locked in a kitchen drawer and inaccessible to residents. FIRE EXTINGUISHER was last purchased on 1/30/2024 is located in the kitchen. First-aid is complete. BEDROOMS: There are four (4) bedrooms designated for client use. All bedrooms are furnished with beds, dresser and required bedding and linen. Extra linen is available in the cabinet at the hallway. The bedrooms have sufficient closet space and have sufficient lighting. Auditory alarms were tested and observed to be operational. Facility will have awake staff. Bedroom #1 and bedroom #2 is for private use located at the left side of the hallway. Bedroom #3 and bedroom #4 is shared located at the right side of the hallway. Continue to LIC 809-C BATHROOMS: At 10:48am the team observed three (3) bathrooms are clean and in good repair. Properly supplied with toilet papers, soap, and paper towels. The hot water temperature measured between 117.5°F. observed appropriate grab bar and had non-skid mat. Bathroom #1 is located in the hallway beside the entrance of the facility. Bathroom #2 is located inside bedroom #3 for private use. Hot water for bathroom #2 measured at 117.2°F. Bathroom #3 is located inside bedroom #4 for private use. Hot water for bathroom #3 measured at 118.1°F. COMMON AREAS: The facility maintains a comfortable temperature at 71°F. The living room and dining appeared clean and were properly furnished. No obstructions and or tripping hazards throughout the facility. Office is located beside the living room and exit to the patio. MEDICATION: The medications will be kept in the kitchen cabinet and the team observed the cabinet kept locked and inaccessible to residents in care. SMOKE DETECTORS/CARBON MONOXIDE. Smoke detectors and carbon monoxide were located throughout the facility. At 10:35am they were tested and observed to be operational. SURROUNDING GROUNDS: In the back of the facility has sufficient yard space. LPAs observed appropriate outdoor furniture, with a covered shaded area for clients. The backyard is fenced. LPAs discussed the importance of maintaining the care and supervision to meet the needs of clients. There are no bodies of water. The driveway passageway and entrance to the home was clear of obstructions. All entry and exit doors have a functional auditory alert when the doors open. GARAGE – there is a garage that is used as a storage and is blocked off to the residents. In addition, LPAs observed laundry room is located in the beside the kitchen. The washer/dryer appear to be in good condition. Laundry supplies are kept lock and inaccessible when not in use with supervision. Component III was conducted with the administrator and licensee. Facility is in compliance with Title 22 Regulations at this time. This report will be forwarded to the Centralized Application Bureau (CAB) and be notified by the CAB Analyst when your license has been approved. Exit interview was conducted and with a copy of this report was provided to the Applicant/Administrator.the state’s words, verbatim · CDSS document, Apr 11, 2024

Type of visit: Office

Facility Type: RCFE Application Type: CHOW Capacity: 6 Census (if any clients in care): 4 COMP II Participants: Siranuysh Gevorkyan/Lic Sona Gevorkyan/Admin Interview Method: Telephone interview On 3/14/24, applicant/administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Mar 14, 2024